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What is scrub typhus, one of the infections suspected to be behind Firozabad ‘mystery’ deaths

The infection affects people of all ages including children, with mortality rates ranging from below 1 per cent to 50 per cent.

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New Delhi: The death toll in Uttar Pradesh’s Firozabad district from a “mystery disease” rose to nearly 100 Sunday.

Speaking to ThePrint Friday, as a five-member National Centre for Disease Control (NCDC) team left for Firozabad to find out the cause, an NCDC official said that apart from dengue, scrub typhus and malaria were among the list of suspected infections causing the deaths.

On Sunday, The Times of India reported that the team had confirmed that the infections had been caused by a dengue outbreak.

However, a state government health department official told the daily that “some isolated cases of malaria and scrub typhus have also been detected in the region”.

ThePrint explains what scrub typhus is, its causes and symptoms.


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The infection

Also known as bush typhus, scrub typhus is a disease caused by bacteria called ‘Orientia tstsugamushi’, which was formerly ‘Rickettsia’.

It typically spread to people through the bites of infected chiggers or larval mites. According to US Centers for Disease Control and Prevention, scrub typhus occurs in rural areas of Southeast Asia, Indonesia, China, Japan, India, and northern Australia.

The infection affects people of all ages including children with mortality rates ranging from below 1 per cent to 50 per cent. An NCDC brief about the infection notes that “in severe cases with pneumonia and myocarditis, the mortality rate may reach 30%”.

The vector is abundant on grasses and herbs where bushes are scarce.

Symptoms of scrub typhus begin within 10 days of being bitten and include fever and chills, headache, body aches, and muscle pain, and a dark, scab-like region at the site of the bite among others. It is diagnosed using blood tests and laboratory tests that determine the presence of the bacterium and can be treated with the antibiotic doxycycline.

Prevalence in India

A 2017 paper in the Indian Journal of Dermatology noted that the disease “is the most common re-emerging Rickettsial infection in Indian and many other South East Asian countries” and nearly a million cases are reported every year in the Asia-Pacific region.

“During the Second World War, scrub typhus emerged out to be the most dreaded disease among the soldiers of the Far East. In India, scrub typhus broke out in an epidemic form in Assam and West Bengal during the Second World War. Gradually, the disease became prevalent in many parts of India,” explained the paper by researchers Sayantani Chakraborty from RG Kar Medical College, and Nilendu Sarma from Postgraduate Institute of Pediatric Science, Kolkata.

According to the National Health Portal, there have been outbreaks of scrub typhus in the sub-Himalayan belt from Jammu to Nagaland and also in Rajasthan.

It notes: “There were reports of scrub typhus outbreaks in Himachal Pradesh, Sikkim and Darjeeling (West Bengal) during 2003-2004 and 2007. Outbreak occurs more frequently during the rainy season however in southern India outbreaks are reported during the cooler months of the year.”


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